Fw: DENDRITE: Stop Forced Outpatient Psychiatric Drugging in New York State

Graeme Bacque (gbacque@idirect.com)
Sat, 20 Mar 1999 20:46:54 -0500


----- Original Message -----
From: David Oaks - Support Coalition International <dendron@efn.org>
To: <dendrite@efn.org>
Sent: Saturday, March 20, 1999 7:48 PM
Subject: DENDRITE: Stop Forced Outpatient Psychiatric Drugging in New York
State



 DENDRITE ALERT -- March 20, 1999 -- Spring to action!
 Copy/post to appropriate places on & off Internet.
 Win human rights in the "mental health system"
 with Support Coalition International.
 web: www.efn.org/~dendron e-mail: dendron@efn.org
 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

     STOP THE SPREAD OF FORCED OUTPATIENT PSYCHIATRIC DRUGGING
     INTO NEW YORK STATE! CONTACT COMMISSIONER JIM STONE NOW!

     RECENT MEDICAL STUDIES SHOW: PSYCHIATRIC DRUGS THAT WOULD
     BE USED, MAY LEAD TO CHANGES IN SIZE AND SHAPE OF BRAIN!

 Nearly 40 states in the USA now have laws allowing courts to order people
 to take powerful psychiatric drugs against their will, even while living
 out in the community in the sanctity of their own homes. These "involuntary
 outpatient commitment" laws are quietly spreading internationally.

 NOW is the time to fax/phone/write to the New York State Commissioner of
 Mental Health to STOP a bill promoting this forced outpatient psychiatric
 drugging. Such a bill can impact everyone by establishing a precedent.

 And this is the same government that says it has a "war against drugs"?

 Whether you live in -- or out -- of New York State, show that the whole
 world is watching! Don't let any more homes be made into wards!

 RECENT BRAIN SCAN STUDIES SHOW THESE PSYCHIATRIC DRUGS CAN LTER BRAIN

 Recent medical studies using CT and MRI scans show that the chemicals used
 in these forced druggings -- the "neuroleptics" such as Haldol, Prolixin,
 Thorazine, Mellaril, Stelazine, Navane, etc. -- may in the long run alter
 the actual size and shape of the brain. [Citations for these two important
 brain scan studies are at THE VERY BOTTOM of this alert: scroll down.]

 These neuroleptic-induced brain changes may explain why quitting
 neuroleptics can cause such a hellish "rebound" effect for months, in which
 the subject may experience worse emotional and mental problems than before
 they even started taking the neuroleptics. Neuroleptic "discontinuation
 syndrome" is often seen in the medical literature. [Citation example: J
 Clin Psychiatry 1997 Jun; 58(6):252-5; "Clozapine withdrawal resulting in
 delirium with psychosis: a report of three cases."]

 Many people willingly choose to take neuroleptics. But forcing these drugs
 into the community is far more insidious than the cigarettes once pushed by
 "Joe Camel." Two studies show African Americans are far more likely to get
 long-acting depot neuroleptics, and at higher doses. [Citations: See
 American Psychiatric Association's _Psychiatric Services_ 3/96 and 1/94.]

 Neuroleptic manfuacturers themselves warn their products are associated
 with the ultimate side effect -- death, such as by neuroleptic malignant
 syndrome, choking, over-heating, "sudden unexplained death," etc.

 The main pusher of the forced drug bill is the extremist Treatment Advocacy
 Center, which is funded by the millionaire Stanley family, and headed by
 psychiatrist E. Fuller Torrey. TAC is misleading the public by calling
 their forced drug proposal "assisted treatment."

 TAC is now lobbying Commissioner Jim Stone. Let him hear from you instead!
 If Commissioner Jim Stone can be convinced not to push this legislation,
 your action may help kill the forced outpatient drugging bill. ACT NOW!

 A sample comment you can send to the Commissioner: "If you endorse
 'customer empowerment,' then are you listening to the thousands of New York
 State psychiatric survivors and allies who are united in opposition to this
 dangerous proposal? Human rights violations don't help anyone!"

    * * * * *  A C T I O N  * * * * *

 WRITE NOW:

 Jim Stone, Commissioner
 New York State Office of Mental Health
 44 Holland Ave
 Albany NY 12229 USA

 FAX NOW: 518-474-2149

 PHONE NOW: 518-474-4403

 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
 citations about brain scan studies at BOTTOM
 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

 YOU CAN GET DENDRITE HUMAN RIGHTS ALERTS & NEWS *FREE*!

 DENDRITE is a public Internet alert system about human
 rights in psychiatry, sponsored by Support Coalition
 International, sending out notices to thousands of
 concerned people, many of whom take ACTION NOW!

 In your brain, dendrites branch like trees to interconnect
 billions of neurons. BRANCH THIS ALERT: Please copy
 & forward to appropriate places on & off the Internet.

 Support Coalition International is an independent
 non-profit federation of more than 70 groups in 11
 countries united to WIN campaigns for human rights in
 the "mental health system." For info on Support
 Coalition, see the web site: www.efn.org/~dendron

 DID YOU SEE DENDRON YET? The winter '99 issue of
 _Dendron News_ #41 published by Support Coalition has
 48 pages exposing coerced psychiatric drugging out in
 the community, plus resources, letters, cartoons,
 poetry, books, and more. To join SCI and get _Dendron
 News_ e-mail your postal address to: dendron@efn.org

 Dendron is the newsjournal for members of Support
 Coalition. DENDRITE is free public e-mail list for all.

 DENDRITE is a one-way occasional e-mail list, so you do
 not get too much e-mail this way. Sign up!

 To get free DENDRITE alerts, simply e-mail to:

 ListProc@efn.org

 with these two words:

 subscribe dendrite

 To unsubscribe from DENDRITE, e-mail to:

 ListProc@efn.org

 with these two words

 unsubscribe dendrite

 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
 CITATIONS ABOUT TWO STUDIES LINKING NEUROLEPTIC
 DRUGS TO CHANGES OF BRAIN SIZE AND SHAPE:
 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

 These two brain scan studies link neuroleptics to changes in the shape of
 the brain: subcortial brain swelling, and frontal brain shrinkage.

 1.  MRI BRAIN SCAN STUDY LINKS NEUROLEPTICS TO BRAIN SIZE/SHAPE HANGE

 This MRI scan study concludes that neuroleptics seem to be responsible for
 subcortical brain swelling.

 To read full article and see MRI scan photos go to:
 http://ajp.psychiatryonline.org/cgi/content/full/155/12/1711

 Citation: American Journal of Psychiatry, December 1998, "Subcortical MRI
 Volumes in Neuroleptic-Naive and Treated Patients with Schizophrenia."

 For a copy of article write to: Dr. Raquel E. Gur; Neuropsychiatry Section;
 University of Pennsylvania Medical Center, 10th Floor; Gates Bldg.;
 Philadelphia, PA 19104 USA.

 2. CT BRAIN SCAN STUDY LINKS NEUROLEPTICS TO BRAIN SIZE/SHAPE HANGE

 Researchers use longitudinal CT scans to reveal frontal brain shrinkage
 associated with neuroleptic use. Conclusion: "The estimated risk of atrophy
 increases by 6.5% for every additional 10 g neuroleptic drug."

 Below is full text. Address to ask researchers in Denmark for a copy of
 study is at bottom.

 Citation:  The Lancet, Sept 5, 1998 v352 n9130 p784(1).

 Title: "Neuroleptics in progressive structural brain abnormalities in
 psychiatric illness."

 Authors: Al Madsen, N Keiding, A Karle, S Esbjerg, R Hemmingsen

 Progressive abnormalities have been reported in
 schizophrenic patients.1 We did a prospective,
 longitudinal study of brain structure. 31 drug-naive
 psychotic patients underwent computed tomography (CT)
 at first admission to hospital and after 5 years of
 illness. We obtained written informed consent from all
 patients. A radiologist masked to the patients'
 identities and diagnoses, date of scans, and the nature
 of the study compared the first and second CT scans.
 Brain atrophy was assessed on a visual scale, on which
 0-1 meant no changes or dubious atrophy and 2-3 meant
 moderate or severe atrophic changes. After 5 years of
 illness, we found significant progression of frontal
 atrophy in 21 schizophrenic patients, compared with
 nine consecutively included healthy volunteers. We saw
 progressive frontal atrophy in ten non-schizophrenic
 patients, but to a lesser degree.

 During follow-up, schizophrenic patients received a
 median of 172040 mg (range 19 540-928450) neuroleptic
 medication (chlorpromazine equivalents). Seven
 non-schizophrenic patients received a median of 20780
 mg (range 678-141596). The only atypical neuroleptic
 used was clozapine, administered to three patients,
 always in high doses and in combination with
 traditional neuroleptics.

 Patients were thought to have a chronic, non-remittent
 course of illness if all psychiatric records described
 a state of permanent psychosis, and if they were
 psychotic at the time of the reinvestigation. Some
 patients were described as remitted, but if in long
 interviews they showed firm delusive systems that
 seemed to be integrated but not necessarily overt parts
 of their lives, and if they were judged to be
 permanently deluded, despite their records, they were
 classified as non-remittent. This classification was
 made without knowledge of the results of the CT scans.
 Nine schizophrenic patients (eight men and one woman)
 had been continuously psychotic during follow-up. At
 reinvestigation, non-remittent patients had
 significantly higher ratings for psychopathology (SANS
 and SAPS2) than remittent patients.

 Because of the small sample, we did exact tests in a
 logistic regression analysis with LogXact, adjusted for
 sex, course of illness, (remission/non-remission),
 diagnosis, and neuroleptic load. Course of illness and
 diagnosis had no significant impact on the development
 of frontal atrophy. Sex was significant (p=0.035) if
 course of illness was not included into the model, but
 sex became non-significant (p=0.138) if course of
 illness was included. Neuroleptic load was significant
 whether sex was included or not (p=0.013 and 0.0003,
 respectively). The estimated risk of atrophy increases
 by 6.4% for each additional 10 g neuroleptic drug.
 Non-remittent patients received a higher neuroleptic
 dose than remittent patients, but the model was
 corrected for this interaction.

 Association has been shown between frontal atrophy or
 aplasia and non-respondence to antipsychotic drugs,3
 and neuroleptic side-effects as tardive dyskinesia and
 akathisia have been associated with wider sulci.4 These
 studies do not include neuroleptic load as a possible
 explanatory factor for the anormalities found.
 Traditional neuroleptics have been shown to affect
 brain structure because they enhance the volume of
 basal ganglia,5 but the potential impact of
 neuroleptics, on frontal cortex, for example, is not
 known.

 Factors causing progression of brain atrophy have not
 yet been identified. Our study showed an unexpected
 effect of neuroleptic medication on cerebral cortex,
 but our analysis suggests that the results cannot be
 taken as accidental. Future longitudinal studies of
 brain structure in schizophrenia are needed to show
 whether atypical antipsychotic drugs may be more
 beneficial.

 1. DeLisi LE, Sakuma M, Tew W, Kushner M, Hoff AL,
 Grimson R. Schizophrenia as a chronic active brain
 process: a study of progressive brain structural change
 subsequent to the onset of schizophrenia. Psychiatr Res
 1997; 7: 129-40.

 2. Andreasen NC, Black DW, Introductory textbook of
 psychiatry. Washington DC: American Psychiatric Press,
 1991.

 3. Friedman L, Knutson L, Shurell M, et al, Prefrontal
 sulcal prominence is inversely related to response to
 clozapine in schizophrenia. Biol Psychiatry 1991; 29:
 865-77.

 4. Sandyk R, Kay SR, Sulcal size and
 neuroleptic-induced akathisia. Biol
 Psychiatry 1990: 27: 466-67.

 5. Frazier JA, Giedd JN, Kaysen D, et al.
 Childhood-onset schizophrenia: brain MRI rescan after 2
 years of clozapine maintenance treatment. Am J
 Psychiatry 1996; 153: 4.

 For copy of study write:

 A. Madsen; Department of Psychiatry E
 Bispebjerh Hospital
 DK 2400 Copenhagen NV Denmark